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      Assessment of Caregiver’s Knowledge, Complementary Feeding Practices, and Adequacy of Nutrient Intake from Homemade Foods for Children of 6–23 Months in Food Insecure Woredas of Wolayita Zone, Ethiopia


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          Complementary feeding should fill the gap in energy and nutrients between estimated daily needs and amount obtained from breastfeeding from 6-month onward. However, homemade complementary foods are often reported for inadequacy in key nutrients despite reports of adequacy for energy and proteins. The aim of this study was to assess caregiver’s complementary feeding knowledge, feeding practices, and to evaluate adequacy daily intakes from homemade complementary foods for children of 6–23 months in food insecure woredas of Wolayita zone, Ethiopia. A cross-sectional study assessing mothers/caregiver’s knowledge and complementary feeding practice, adequacy of daily energy, and selected micronutrient intakes using weighed food record method. Multi-stage cluster sampling method was also used to select 68 households. Caregivers had good complementary feeding knowledge. Sixty (88.2%) children started complementary feeding at 6 months and 48 (70.6%) were fed three or more times per day. Daily energy intake, however, was significantly lower ( p < 0.05) than estimated daily needs, with only 151.25, 253.77, and 364.76 (kcal/day) for 6–8, 9–11, and 12–23 months, respectively. Similarly, Ca and Zn intakes (milligrams per day) were below the daily requirements ( p = 0.000), with value of 37.76, 0.96; 18.83, 1.21; 30.13, 1.96; for the 6–8, 9–11, and 12–23 months, respectively. Significant shortfall in daily intake of Fe ( p = 0.000) was observed among the 6–8 and 9–11 months (3.25 and 4.17 mg/day, respectively), even accounting for high bioavailability. The complementary foods were energy dense. Daily energy, Ca, Zn, and Fe (except 12–23 months) intake, however, was lower than estimated daily requirements.

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          Update on technical issues concerning complementary feeding of young children in developing countries and implications for intervention programs.

          This paper provides an update to the 1998 WHO/UNICEF report on complementary feeding. New research findings are generally consistent with the guidelines in that report, but the adoption of new energy and micronutrient requirements for infants and young children will result in lower recommendations regarding minimum meal frequency and energy density of complementary foods, and will alter the list of "problem nutrients." Without fortification, the densities of iron, zinc, and vitamin B6 in complementary foods are often inadequate, and the intake of other nutrients may also be low in some populations. Strategies for obtaining the needed amounts of problem nutrients, as well as optimizing breastmilk intake when other foods are added to the diet, are discussed. The impact of complementary feeding interventions on child growth has been variable, which calls attention to the need for more comprehensive programs. A six-step approach to planning, implementing, and evaluating such programs is recommended.
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            A review of phytate, iron, zinc, and calcium concentrations in plant-based complementary foods used in low-income countries and implications for bioavailability.

            Plant-based complementary foods often contain high levels of phytate, a potent inhibitor of iron, zinc, and calcium absorption. This review summarizes the concentrations of phytate (as hexa- and penta-inositol phosphate), iron, zinc, and calcium and the corresponding phytate:mineral molar ratios in 26 indigenous and 27 commercially processed plant-based complementary foods sold in low-income countries. Phytate concentrations were highest in complementary foods based on unrefined cereals and legumes (approximately 600 mg/100 g dry weight), followed by refined cereals (approximately 100 mg/100 g dry weight) and then starchy roots and tubers (< 20 mg/100 g dry weight); mineral concentrations followed the same trend. Sixty-two percent (16/26) of the indigenous and 37% (10/27) of the processed complementary foods had at least two phytate:mineral molar ratios (used to estimate relative mineral bioavailability) that exceeded suggested desirable levels for mineral absorption (i.e., phytate:iron < 1, phytate:zinc < 18, phytate:calcium < 0.17). Desirable molar ratios for phytate:iron, phytate:zinc, and phytate:calcium were achieved for 25%, 70%, and 57%, respectively, of the complementary foods presented, often through enrichment with animal-source foods and/or fortification with minerals. Dephytinization, either in the household or commercially, can potentially enhance mineral absorption in high-phytate complementary foods, although probably not enough to overcome the shortfalls in iron, zinc, and calcium content of plant-based complementary foods used in low-income countries. Instead, to ensure the World Health Organization estimated needs for these minerals from plant-based complementary foods for breastfed infants are met, dephytinization must be combined with enrichment with animal-source foods and/or fortification with appropriate levels and forms of mineral fortificants.
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              Phytate, zinc, iron and calcium content of selected raw and prepared foods consumed in rural Sidama, Southern Ethiopia, and implications for bioavailability


                Author and article information

                URI : http://frontiersin.org/people/u/367008
                URI : http://frontiersin.org/people/u/353518
                URI : http://frontiersin.org/people/u/293753
                Front Nutr
                Front Nutr
                Front. Nutr.
                Frontiers in Nutrition
                Frontiers Media S.A.
                15 August 2016
                : 3
                : 32
                [1] 1John Snow, Inc (JSI)-Ethiopia , Addis Ababa, Ethiopia
                [2] 2Addis Ababa University , Addis Ababa, Ethiopia
                [3] 3Micronutrient Initiative-Africa , Addis Ababa, Ethiopia
                [4] 4University of Botswana , Gaborone, Botswana
                [5] 5Micronutrient Initiative-Ethiopia , Addis Ababa, Ethiopia
                [6] 6Ethiopian Public Health Institute , Addis Ababa, Ethiopia
                Author notes

                Edited by: António Manuel Peres, Polytechnic Institute of Bragança, Portugal

                Reviewed by: Gael Janine Mearns, Auckland University of Technology, New Zealand; Vera Ferro Lebres, Polytechnic Institute of Bragança, Portugal

                *Correspondence: Motuma Adimasu Abeshu, motumad4@ 123456gmail.com

                Specialty section: This article was submitted to Nutrition and Food Science Technology, a section of the journal Frontiers in Nutrition

                Copyright © 2016 Abeshu, Adish, Haki, Lelisa and Geleta.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                : 02 June 2016
                : 29 July 2016
                Page count
                Figures: 6, Tables: 8, Equations: 1, References: 41, Pages: 12, Words: 7960
                Funded by: Micronutrient Initiative (MI)
                Award ID: 10-1314-ADIMAS-29
                Original Research

                complementary feeding,children,nutrient density,homemade,estimated daily nutrient intake


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